Should I call the doctor if my child has a cough?

If your child's cough doesn't get better after about a week, yes. And, of course, if your child ever seems to be having serious trouble breathing, call 911 right away. But in general, it's time to call the doctor if your child has a cough and:

is younger than 3 months old

is breathing more rapidly than usual or looks like he's working harder to breathe

is wheezing

is coughing up mucus that's yellow, green, or blood-streaked

has a fever of at least 101 degrees Fahrenheit if he's 3 to 6 months old

has a fever of at least 103 degrees Fahrenheit if he's 6 months or older

Can I give my child cough medicine?

Even if you think it's just a cold, ask the doctor before giving your child over-the-counter cough or cold medicine.

Most doctors discourage giving these medications to young children. The American Academy of Pediatrics cautions parents never to use these products for children younger than 4. And even for children age 4 to 6, use these medications only if your child's doctor recommends it.

Once your child is 6 years old, you can give him an over-the-counter cough or cold medicine – just make sure it's appropriate for his age and measure each dose exactly according to the directions. Also, never give your child more than one type of cough or cold medicine at a time. They often include multiple ingredients, and you wouldn't want to give your child a double dose of any of them.

For tips on other ways to soothe your child's cough and cold symptoms, see our article on safe home remedies.

What could be causing my child's cough?

There are lots of possibilities, and some will warrant a call to your child's doctor. Here are some of the most common causes of a cough:

The common cold

If your child has a cold, he may be coughing and sneezing with a runny or stuffy nose, watery eyes, little or no appetite, and possibly a low fever.

Respiratory syncytial virus

Respiratory syncytial virus (RSV) is most common in babies and young children, though children of any age can get it. Symptoms of RSV are similar to cold symptoms but with a worsening cough and labored breathing in addition.

RSV usually strikes between November and mid-March, and sometimes it's no more troublesome than a cold. But it can lead to more serious respiratory illnesses, such as bronchiolitis (inflammation of the small breathing tubes) and pneumonia (inflammation of the lungs), especially in babies less than a year old.

Croup

The hallmark of croup is a deep cough that sounds like a bark and is often worse at night. Croup can also cause stridor (a high-pitched whistling sound) when your child breathes in.

As horrible as this cough can sound, in most cases it's not too serious and can be treated at home. Still, it couldn't hurt to call your doctor for advice. She may want you to bring in your child for an examination.

Allergies, asthma, and environmental irritants

A child who's allergic to something in his environment, such as cat dander or dust mites, may seem to have a cold that never goes away. Allergies can cause a stuffy or runny nose with clear mucus as well as a cough from the constant postnasal drip (mucus running down the back of his sinuses into his throat).

Children with asthma tend to cough a lot, too, especially at night. If your child has asthma he may also have chest congestion, wheezing, and difficulty breathing. If your child starts coughing after he's been running around (exercise-induced asthma), that's another clue that asthma may be to blame. Exposure to cold can also trigger a cough in a child with asthma.

Another possibility is that an environmental irritant, like cigarette smoke or pollution, is making your child cough. Of course, in this case you'll want to identify and eliminate the problem right away.

Pneumonia or Bronchitis

Many cases of pneumonia, an infection in the lungs, start out as a cold. If your child has a cold that seems to be getting worse, a persistent cough, difficulty breathing, a fever, body aches, and chills, call his doctor for an appointment.

Bronchitis results when the bronchi (tubes that carry air to the lungs) become infected, often after a cold or flu. It can cause a nagging cough for several weeks.

If your child has bacterial pneumonia or bronchitis, he may need an antibiotic to clear up the infection and cough. (If the infection is viral, he'll get better without antibiotics.)

Sinusitis

If he has a cough and a runny nose that has lasted for at least 10 days with no sign of improvement – and your doctor has ruled out pneumonia and bronchitis – your child may have sinusitis. This bacterial infection of the sinus cavities causes a lingering cough because mucus is constantly draining down the back of the throat, triggering the cough reflex.

If the doctor determines that your child has sinusitis, she'll prescribe an antibiotic. The cough should stop after the sinuses are clear again.

Swallowing or inhaling an object

A cough that has persisted for a week or more without any other signs of illness (like runny nose, fever, or lethargy) or allergies (clear discharge) could mean that your child has something stuck in his throat or lungs. This scenario is more common among small children who are mobile, have access to small objects, and like to put things in their mouth.

If your child's doctor suspects that a foreign body is causing the cough, she'll order a chest X-ray. If it shows something trapped in the lungs, the object will have to be removed surgically.

Whooping cough

Whooping cough, also known as pertussis, has become less common thanks to widespread use of the DTaP vaccine, but outbreaks still occur and in some places are on the rise. More than 48,000 cases were reported in the United States in 2012.

A child with whooping cough typically coughs nonstop for 20 or 30 seconds, and then struggles to breathe before the next coughing spell starts. Your child may also have cold symptoms, such as sneezing, runny nose, and a mild cough, for up to two weeks before more severe coughing spells begin. If this sounds like what your child has, call his doctor right away. Whooping cough can be severe, especially in babies younger than a year old.

Cystic fibrosis

Cystic fibrosis affects about 1 in 3,000 children in the United States, and a constant cough with thick yellow or green mucus is one of the strongest indications that a child may have inherited the condition. Other signs include recurrent pneumonia and sinus infections, not gaining weight, salty-tasting skin, and large, greasy stools.

Habit

Sometimes a child develops a cough from an illness and continues to cough out of habit, even after he's otherwise healthy. If your child is coughing out of habit, he won't do it while he's sleeping, and it will rarely interfere with his eating or speaking. However, it can be disruptive (in a classroom, for example).

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